Tips for Filling a Vital Role in Healthcare
Nursing is the largest single component of the hospital workforce. Nothing has a greater impact on quality of care than nursing leadership and front-line care providers, and no one is more trusted in the U.S. workforce than nurses. From the Director of Nursing to nursing assistants, nursing talent drives quality outcomes, care efficiency, and patient satisfaction.
In a tight labor market, however, it is difficult to find enough qualified nurses to fill open positions. This isn’t a newsflash to the healthcare industry – there’s been a shortage of qualified nursing applicants for years. This talent shortage is exacerbated by poor retention of existing nurses. First-year turnover in the hospital sector is 28.3 percent, which is significantly higher than the rest of U.S. industries at 21.5 percent. This talent picture isn’t likely to get better anytime soon. As of December 2018, the national unemployment rate was tracking below 4 percent – the lowest since the late 1960s – so it’s likely that filling any patient-facing job is going to get much tougher.
Consider the three-pronged approach some of the most successful organizations take when selecting and on-boarding nurses and nursing managers:
- Define important behavioral competencies.
Traditional selection strategies for nurses generally do an adequate job evaluating knowledge, training and technical skills. Where they fail is in the areas of motivational fit (work schedule, pace of work, amount of autonomy or teamwork, and time spent with patients), and evaluating behavioral competencies. These include emotional intelligence, collaboration, patient focus, resiliency, and adaptability. Successful organizations take the time to clearly define these critical characteristics so they can be systematically evaluated and considered when making hiring decisions.
- Become better at interviewing candidates.
Almost every selection process includes at least one interview. And in many cases, the process may include multiple interviews! But an all-too-common problem is that these interviews are conducted by poorly trained interviewers who operate outside the bounds of a well-designed process. Decades of research demonstrate that these unstructured interviews have almost no value when it comes to predicting success on the job or retention. You may as well flip a coin to decide who gets an offer.
Successful organizations take a very different approach. They ensure that interviewers are trained and provided with a concise, easy-to-use, consistent interview guide built around validated job competencies. Here again the research evidence is clear, these two simple steps dramatically improve the predictive power of the interview!
- Use proven behavioral assessments to examine functional competencies.
Nearly 75 percent of successful companies in other industries increase their odds of selecting the right candidate – and reducing turnover – with pre-employment behavioral assessments. But with a shortage of candidates and higher-than-average turnover, screening and testing efforts get branded as “hiring obstacles.” These organizations are tempted to abandon assessments because of a short-sighted view of how to use these tools. The opportunity to save time and money adds to the allure of ditching assessments and short-cutting the hiring process.
But successful organizations understand that cutting back on efforts to gain insights into candidates’ skills and motivations can have significant, negative consequences. Viewing assessment only as a barrier to filling jobs rests on flawed thinking about how well-designed assessments should be used.
Screen In vs. Screen Out
While it’s natural to view assessments as screening steps to de-select “unqualified” candidates, that’s only one of the ways savvy recruiters use assessment results. In a seller’s market for talent, assessments can quickly identify highly qualified applicants so you can accelerate them through your process and put them first in line for interviews. Without the insights provided by an automated screening tool, top candidates end up waiting in line behind the mediocre ones. And that top talent has options – if you don’t move fast, they’ll be hired by a competitor before you get to them.
As noted earlier, retention is a huge issue within patient-facing jobs. This is a costly problem that jeopardizes patient satisfaction, patient safety, and the quality of clinical outcomes – three metrics of vital importance to healthcare providers. In fact, it’s estimated that the turnover cost is 1.5 times the base salary for exempt employees. The average hospital is estimated to lose about $300,000 per year for each percentage increase in annual nurse turnover.
It’s common sense to use an assessment to de-select candidates that show a high risk for turnover. However, experienced leaders use insights gained about workers’ preferences and motivations to build retention strategies that bind employees to the organization. Without this assessment data, even the most conscientious leader may require weeks, or even months, to gain the insights needed to craft and execute an effective, individualized retention strategy.
Personalized Development Plans
Employee surveys consistently show that healthcare workers value development on the job, and the failure to provide meaningful and relevant development support is one of the key causes of turnover. Far too often, employee development takes a “cookie cutter” approach where people sit in classes or take online courses that have little perceived relevance to their roles and in which they have little interest. A well-designed pre-employment screening tool enables leaders and their HR partners to sit down with new hires in the first week of employment to review assessment results and craft a personalized plan that engages the employee and energizes them for further development.
Having development plans in place within the first two weeks of an employee’s tenure not only helps with retention, it also allows leaders to rapidly mitigate any skill deficiencies. Without the information provided by a pre-employment assessment, leaders only end up discovering these deficiencies through experience – if at all.
The nursing shortage is a complex, costly problem. It requires a thoughtful and comprehensive strategy that starts with a structured and diligent three-step selection process that allows organizations to quickly select top talent and inoculate against turnover. Assessment processes that provide deep insights into candidates’ skills and motivation are not barriers to hire. When properly understood they can be the signposts that point the way to addressing the nursing talent challenge.
Before you press the reset button on your hiring and testing process, ask yourself if you’re still operating with a “screen out” mindset. Rethinking how and why you use tools may actually help your organization thrive in this tough market for talent.
Written by: Jim Thomas, Ph.D., Vice President, PSI Services
Jim Thomas, Ph.D., is a PSI Services vice president who’s held a variety of roles spanning consulting, business development, and general management in his 30+ years as an Industrial Psychologist. His work developing assessment and diagnostic solutions has literally taken him around the world, including extended assignments to the Middle East and China.